National Tobacco Control Program

(NTCP)

Introduction

• TOBACCO CONTROL ACT, 2003 – Cigarette and Other Tobacco Products Act’ 2003 has been

implemented in the State of Punjab in letter & spirit.

Click here to view

http://pbhealth.gov.in/tob/TOBACCO%20CONTROL%20ACT,%2018th%20May%202003.pdf

• SCOPE OF THE ACT – The Act is applicable to all products containing Tobacco in

any form i.e. Cigarettes, Cigars, Cheroots, Bidis, Gutkha, Pan masala (containing tobacco) Khaini, Mawa, Mishri, Snuff etc. as detailed in the schedule to the Act.

– The Act extends to whole of India.

Tobacco Prevalence in Punjab

As per GATS 2010 report, about 12% of population in Punjab uses Tobacco in any form.

Considering the population of 2.75 Crores, 33 lakh population in Punjab uses Tobacco in some form or the other.

More than 2200 Indians and about 48 persons of Punjab die every day due to tobacco use………

Prevalence of Tobacco Use in Punjab

Tobacco Smoke Free Districts of Punjab

• Under the campaign of making Punjab Tobacco Smoke Free : – Twenty Two Districts SAS Nagar (Mohali), Mansa,

Amritsar, Roopnagar, Gurdaspur, Fatehgarh Sahib, Saheed Bhagat Singh Nagar (Nawanshar), Sangrur, Hoshiarpur, Kapurthala, Sri Muktsar Sahib, Bathinda, Faridkot, Ferozepur, Fazilka Patiala, Jalandhar, Barnala,Tarn taran, Pathankot, Moga & Ludhiana have been declared as 'Tobacco Smoke Free' (TSF) on the basis of compliance study report by School of Public Health, PGIMER Chandigarh.

MAIN OUTCOMES (IN TERMS OF SEC-4,SEC 6) % OF

COMPLIANCE AS REPORTED BY PGI CHANDIGARH

State/District Level Activities

• Every year 31st May is celebrated as “World No Tobacco Day”. • This year World No Tobacco Day was celebrated as " NO

TOBACCO PLEDGE DAY" in all Govt. & private educational institutions

• Meeting of State level Coordination Committee held under the Chairpersonship of Principal Secretary, Health & Family Welfare, Punjab on 03-02-2014, 27-11-14 & 16-04-15

• Monthly monitoring at State level in Civil Surgeon Conference and at District level in District Health Society.

• Guidelines for implementation of "Smoke Free Rules" and Health Workers Guide released on 20-4-13.

• Section 5 (Tobacco Advertisement Point of Sale) of COTPA is also being implemented simultaneously. Survey has been done in all the districts to assess the implementation. The implementation has been found to be satisfactory.

STATUS OF IMPLEMENTATION OF ANTI-TOBACCO LAW(COTPA) IN

PUNJAB

MPOWER

Action Area

Main Challenges and Barriers

Present Status

Monitor the

tobacco

epidemic

Plethora of tobacco products available

Surveillance of tobacco use not integrated with on-going health surveys.[NCD Steps]

GATS-Global Adult Tobacco Survey. Tobacco prevalence data is available from: National Family Health Survey (NFHS)-Expenditure surveys such as National

Sample Survey Organization (NSSO) Global Youth Tobacco Survey Compliance surveys performed by School of Public Health, PGI Chandigarh in 20

districts

Protect

people from

tobacco

smoke

Low level of awareness about the harmful effects of tobacco use.

Limited capacity of the states to implement the provisions of COTPA.

Limited reach of the NTCP (21 states covering 42 districts only)Punjab still not covered under NTCP

“The Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade & Commerce, Production, Supply and Distribution) Act, 2003 (COTPA) , Prohibits Smoking in all Public Places.

SAS Nagar, Mansa, Amritsar, Roop Nagar, Shaheed Bhagat Singh Nagar, Fatehgarh Sahib, Gurdaspur, Sangrur, Sri Muktsar Sahib,Kapurthala,Hoshiarpur,Bathinda, Faridkot, Fazilka, Ferozepur Patiala, Jalandhar,Barnala, Tarntaran, Pathankot , Moga & Ludhiana have already been declared as “Tobacco Smoke Free Districts” on the basis of Compliance Study by the School of Public Health, PGIMER, Chandigarh.

Regular monthly monitoring of implementation of COTPA. Permanent District Task Force has been constituted in all the districts for

monitoring of COTPA and abuse of Nicotine January 2013 to Dec 2013, 22099 violators have been challaned. From the April 15 to October 15, 12845 violators have been Challaned.

Govt. of Punjab issued DO letters to all the Deputy Commissioners & Civil Surgeons to promulgate Section 144 against Hukkah bars as they violate all section of COTPA.

State Level Coordination Committee for Tobacco Control has been notified.and met twice this year

Chief Secretary Punjab has written a DO to all DCs

MPOWER Action

Area

Main Challenges and Barriers

Present Status

Offer help to

those who want

to quit

Lack of cessation facilities.

Limited trained manpower on cessation.

Cessation services not mainstreamed in the primary health care delivery mechanism

Limited trained manpower on cessation.

De-addiction centres present in all Districts.

They are providing cessation services.

Orientation workshop of Psychiatrists and Psychiatric social workers conducted on 30-10-14 at GMC Fkt

MPOWER

Action Area Main Challenges and Barriers Present Status

Warn about

the harm of

tobacco

Many tobacco products are unbranded, so they do not have pictorial warnings.

PW’s cover only the front panel and size is not compliant to FCTC standards, whereas Mass media campaigns on air only for 3-4 months in a year.

No comprehensive media strategy.

Section 7 -COTPA 2003 The COTPA,2003 mandates display of Pictorial Health Warnings on all tobacco product packs.

The health warnings occupy presently 40% of principal display area only on front side of the pack. It has been increased to 85% wef from April 15 (communication from GoI awaited)

Sale of loose tobacco & cigarettes in the State has been banned wef 6/1/15

MPOWER

Action Area

Main Challenges and Barriers Present Status

Enforce bans

on

advertising,

promotions &

sponsorship

Multiple litigations by tobacco Industry and its front groups.

Loop hole in COTPA which allows point of sale advertisement of tobacco products.

Other laws are not aligned to COTPA will gives space for surrogate advertisement.

Limited capacity of the states to implement TAPS (Tobacco Adult Promotion & sponsorship).

No guidelines for its implementation.

Section 5- COTPA 2003 : The anti-tobacco legislation, COTPA, prohibits direct/indirect advertising, promotion and sponsorship of tobacco products

The amended rules of 2005 provide for: Ban on sale of tobacco products through vending machines Ban on sale of tobacco products by minors Restrictions on the content, size and number of point of sale of advertisements Ban on visible stacking of tobacco products at the point of sale to prevent easy

access to minors To prevent brand sharing and surrogate advertising of tobacco products;

‘indirect advertising’ has been comprehensively defined. Restrictions on display of tobacco products or their use in movies or television. DO No. P-16011/04/09-PH- 1 dated 24-11-11 written to all State Transport

Commissioners /secretaries regarding banning of advertisement of Tobacco products.

Recently notices have been issued to Tobacco product vendors to remove advertisement on point of sale.

Section 5 (Tobacco Advertisement Point of Sale) of COTPA is also being implemented simultaneously. Survey has been done in all the districts to assess the implementation. The implementation has been found to be satisfactory.

Raise taxes

on tobacco

products

Plethora of tobacco products and large unregulated and unorganised market

Differential taxation of tobacco products.

Distinction between handmade and machine made bidi and bidi units producing less than 2 million sticks/per annum exempted from paying taxes.

Taxes on tobacco products in India fall well below the rate recommended by the World Bank from 65% to 80% of retail price. VAT on Cigarettes in Punjab has been increased to 30% plus cess from 20%

Action taken under Food Safety Standard Act (FSSAI)

Action

Area Main Challenges and Barriers Present Status

Smokeless

Tobacco

products/

chewable

tobacco

Gutkha/Pan masala and other chewable tobacco products are freely available in market in small pouches of Rs1/- each. Can be readily purchased by even students and low income group people. 90% of the oral Cancers are attributed to consumption of chewable tobacco products

Prohibition of Manufacture, sale & Consumption of Smoke Less/chewable products in Punjab has been done w.e.f dated 05/09/12 under section 2.3.4.of FSSA as 90% of the Oral Cancer cases are attributed to consumption of chewable tobacco products.

Flavored Tobacco has been banned wef 28/11/14 2 truck loads seized in Patiala and action initiated under FSSAI

* Source: GATS Survey

Action to be taken against Sale of Electronic

Nicotine Delivery System (ENDS)/ E-Cigarettes

Action

Area Main Challenges and Barriers Present Status

Electronic

Nicotine

Delivery

System (E-

Cigarettes)

These are comparatively new developments. These devices contain nicotine in chemical form which is highly addictive and can be lethal if ingested accidently especially by children.

A meeting was organised by MoHFW on 10-07-13 to formulate guidelines for regulating manufacture and sale of E-Cigarettes in India under the chairpersonship of JS (SG), MohFW, GoI. State Drug Controller, FDA Punjab & State Nodal Officer, Tobacco control cell, Punjab participated & presented a protocol which can be followed for this purpose. Minutes of Meeting have been circulated to all participants. SDC has issued a letter to all DIs that sale of E-Cigarettes is illegal under Drugs and Cosmetics act. E-Cigarettes seized in three districts and court cases launched under Drugs and Cosmetics Act Click here to view http://pbhealth.gov.in/ban_e-CIgg.pdf

Notifications for COTPA

Implementation

Notifications for COTPA Implementation

Notification to authorize the competent persons to Act against any person who commits any offence under Section 4 or Section 6 of the said Act , at any Public Place issued on 24th May 2010.

Click here to view

http://pbhealth.gov.in/tob/Authorized%20officials%20under%20Section%204%20&%206%20Notification%20No.%201022%20Dated%2024-5-2010.pdf

Notifications Contd……

Notification regarding constitution of District and State Level Tobacco Control Committees issued on 20th May 2008.

Click here to view

http://pbhealth.gov.in/tob/State%20level%20and%20District%20Level%20Tobacco%20Control%20Committe

e%20No.%20945%20Dated%2020-5-2008.pdf

Notifications Contd……

Notification regarding constitution of Permanent District Task Force issued on 09-04-2014 to monitor COTPA and abuse of Nicotine in chemical form.

http://pbhealth.gov.in/Notification%209-04-14.pdf

Notification regarding Constitution of State Level & District Level Monitoring Committees issued on 17th January, 2013.

Click here to view

http://pbhealth.gov.in/tob/State%20Level%20&%20District%20Level%20Tobacco%20Monitoring%20Committee%20Notification%20No.%20151%20Dated%2017-1-2013.pdf

Notifications Contd……

Notifications Contd……

Notification to authorize Public Analyst, State Food Lab, Chandigarh as competent authority to test Tobacco and Nicotine in any product.

Click here to view

http://pbhealth.gov.in/tob/tbc_noti.pdf

Notifications Contd……

Notification for prohibition of Manufacture, sale & Consumption of Smoke Less/chewable products including flavoured Tobacco in Punjab has been done under FSSA.

Click here to view

http://pbhealth.gov.in/ban_gutkhka.pdf

Incorporating the condition of COTPA for granting licenses

Punjab Govt. issued an circular regarding incorporating the implementation of COTPA in general conditions for granting License to any commercial establishment.

Notifications regarding ban on Loose Cigarette/Tobacco

Inclusion of COTPA in monthly crime review meetings

Police Department issued an circular regarding inclusion of COTPA in monthly crime review meetings.

Capacity Building

• Various Workshops have been organized by World Health Organization,

International Union against Tuberculosis & Lung Diseases & other NGOs for capacity building.

• These workshops have been attended by State & District level Officers.

• Advocacy workshop for Media and NGOs 27-1-14

• SLCC Meeting 3-2-14 and 27-11-14

• Advocacy workshop for Nicotine Abuse 11-3-14

• Workshop of Psychiatrists & Psychiatrist Social workers held on 30-10-14 for Tobacco/Nicotine de-addiction

• Achievement of Punjab in Tobacco Control

recognised in world forums. Papers regarding

Tobacco Smoke Free Punjab and ENDS accepted in

World Lung Conference Barcelona held on 1/11/14

and National Conference on Tobacco or Health

being held in Mumbai on 15thDecember 2014.

• An article on E-Cigarettes by SPO was published in

International Journal - Tobacco Control.

Recognition at National/International Levels

Challans Issued to Violators

Year Wise Detail of Challans

S.No.

Year

No. of Challans

1. Oct.2008 to December 2010 1848

2. Year 2011 1831

3. Year 2012 13090

4. Jan, 13 to Dec 2013 23968 5 Jan. 2014 to March 2015 22702 6 April 2015 to October 2015 12845

Release of Guidelines for Implementation of Smoke Free Rules & Health workers Guide by Punjab Govt.

• On the occasion of State Level meeting Guidelines for implementation of Smoke Free Rules & Tobacco Free Educational Institutions & Health Workers Guide have been released by, Principal Secretary Health and Family Welfare, Punjab on 1oth April 2013 .

• Guidelines will help District & Sub District Level law implementers for effective implementation of COTPA Act, 2003 to make Punjab a Tobacco Smoke Free State.

• Health Workers Guide will help in sensitization of Field level Health Workers about the law & importance of it’s effective implementation. It contains details of health

effects of tobacco on human body.

Click here to view

http://pbhealth.gov.in/Health%20Workers%20Guide.pdf

RAID AT HUKKAH BAR

Surprise Raid at Hookah Bar

• Surprise raids were made at Hookah Bar named “ Nawab Cafe” on 11th April 2013 & “Arabic Infusion” on 31st Dec 2013 in Mohali. Sample suspected of containing Nicotine and Tobacco has been seized by Health Department and sent to Lab for testing.

• Appropriate Action will be taken by the department

after getting the test reports.

Newspaper Cutting

Electronic Nicotine Delivery System (E-Cigarettes) have been seized in Hoshiarpur, Mohali & Ludhiana w.e.f. July 2014 to October 2014 & action initiated under Drugs and Cosmetics Act.

E-Cigarettes seized in State

Tobacco seized in State

Two trucks loaded

with Tobacco have

been seized by

Health Department in

Patiala.

Letter From Chief Secretary, Punjab

Chief Secretary Punjab has issued instructions to all DCs and Principal Secretaries of all stakeholder deptts to implement Anti-Tobacco law strictly

English Translation of DO issued by CS The Chief Secretary,

Government of Punjab (Branch-……….)

To,

All Deputy Commissioners & Senior Superintendents of Police, State of Punjab No. Dated Chd, 2014

Subject: Strict implementation of all sections of Cigarettes and Other Tobacco Products Act (COTPA) 2003/Ban on chewing Tobacco under FSAAI/ Ban on Nicotine in Chemical form e.g. E-Cigarette under Drug & Cosmetic Act

You are quite aware of the fact that Tobacco consumption is very harmful and leads to many life threatening conditions like Cancer and Cardiovascular diseases. Annually it kills more than 12 Lakh People in India. Not only smokers, non-smokers are also its victims. Nearly 15% of young children in the age group of 13-15 yrs use Tobacco in Smoke form or other form (GYTS-2009) while 27.4 % boys and 8.3 % of girls in the age group of 15-24 yrs use tobacco (GATS). 32% of the Non-smokers at workplaces and 75% non-smokers at home are exposed to Second Hand Smoke. In the state of Punjab 12% of people are Tobacco users while 24% are exposed to Second Hand Smoke at work place & home. This is alarming and the Government of India has enacted COTPA-2003. It is the proper implementation of the Act which can safeguard the precious lives of the innocent people.

Punjab Government has initiated various measures to implement COTPA 2003. 18 districts have already been declared Tobacco Smoke Free after Compliance Study by School of Public Health PGI Chandigarh. Efforts are going on to get the remaining districts also declared as Tobacco Smoke Free. Continuous efforts are required to maintain the Tobacco Smoke free status.

Govt. of Punjab has also incorporated the implementation of COTPA in general conditions for granting licence to commercial establishments. If any violation found/noticed, license will be cancelled. Govt. of Punjab has also banned Gutkha and other food products containing Tobacco/Nicotine. Electronic Nicotine Delivery System (E-Cigarettes) has also been declared as illegal in Punjab under Drugs and Cosmetics act.

Sections of COTPA Penalties (Fine or imprisonment or both) Section 4: Prohibition on smoking in a public places

a) To the individual offender: Up to Rs.200/- b) To owner, manager or authorized officer: Fine equivalent to number of offences in public place

Section 5: Prohibition on advertisements of cigarettes and other tobacco products

a) 1st Offence: 2years/ Rs. 1000/- b) 2nd Offence: 5 years/ Rs. 5000/-

Section 6: Prohibition on the sale to minors and around educational institutes

Up to Rs. 200/-

Section 7, 8 & 9: Prohibition on the sale of Cigarettes & Other tobacco products without specific warnings

a) Manufacturer: 1st Offence: 2years/ Rs. 5000/- 2nd Offence: 5 years/ Rs. 10,000/-

b) Selling/Retailing 1st Offence: 1 years/ Rs. 1000/- 2nd Offence: 2 years/ Rs. 3,000/-

Ban on manufacture, sale or distribution of Gutkha, Pan Masala or any other food ingredient containing tobacco or Nicotine as one of the ingredients under Food Safety & Standard Act

Ban on ENDS/E-Cigarette under Drugs & Cosmetics Act

From the monthly reports regarding IEC and Challaning activities under COTPA, it has been

observed that most of these activities are being undertaken by Department of Health and Family Welfare. Participation of all Departments e.g. Police, Education, Local Govt., Transport, Excise and Taxation etc. are required for effective implementation. HODs of all the Departments must monitor the monthly reports at District and State level as per enclosed Format.

Block level Task force should be constituted by Deputy Commissioner on the pattern of Permanent District Level Task Force already in place for monitoring implementation of COTPA/ Gutkha ban/ Hukkah bars/E-Cigarettes etc.

In the next State Level Coordination Committee (SLCC) to be held shortly District wise and Department wise reports will be discussed. Encl: 1. Monitoring Formats 2. SLCC Notification 3. Circular regarding cancellation of license Chief Secretary, Government of Punjab

Ends. No. Misl./PB/2014 Dated, Chd, 2014

A copy forwarded to

1. The Principal Secretary, Govt. Of Punjab, Deptt. Of Home 2. The Principal Secretary, Govt. Of Punjab, Dept. Of Health & Family Welfare 3. The Principal Secretary, Govt. Of Punjab, Rural Development 4. The Principal Secretary, Govt. Of Punjab, Deptt. Of Finance 5. The Principal Secretary, Govt. Of Punjab, Excise & Taxation 6. The Principal Secretary, Govt. Of Punjab, School Education 7. The Principal Secretary, Govt. Of Punjab, Higher Education 8. Secretary, Govt. Of Punjab, Transport 9. Secretary Public Relations/Information, Punjab 10. Secretary, Govt. Of Punjab, Local Govt. 11. Secretary, Govt. Of Punjab, Labour 12. Secretary Health cum M.D. , NHM Punjab 13. Legal Remembrance 14. Divisional Manager (Ambala Cantt & Ferozepur) from Department of Railways 15. Director Health & Family Welfare, Punjab for information & necessary action please.

Chief Secretary, Government of Punjab

Letter From DGSE to all Schools

Letter issued from DGSE to all schools for making all schools Tobacco Free Schools.

Partnering together to fulfill the vision of tobacco free

Punjab